CEHRS Exam Guide: The NHA Certified Electronic Health Records Specialist Exam, Explained
The Certified Electronic Health Records Specialist (CEHRS) is the National Healthcareer Association’s credential for the people who keep a practice’s electronic health record trustworthy: documentation integrity, system training, privacy and access control, data exchange, and reporting. This guide explains the exam from NHA’s own published materials — eligibility, content, scoring, retakes, and keeping the credential current.
Who is eligible
NHA offers two routes. Under the training route, you complete an electronic health records training or education program within the last five years. Under the experience route, you document at least one year of supervised health-records work experience within the last three years, or two years within the last five. Both routes require a high school diploma or GED; candidates who expect to earn the diploma within 18 months may test under NHA’s provisional window.
The exam at a glance
| Questions | 125 (100 scored + 25 unscored pretest) |
| Time | 125 minutes |
| Format | Multiple choice |
| Delivery | At your school, at a PSI testing center, or by live remote proctoring |
| Results | Posted online, typically within two days |
| Passing | Scaled score of 390 on a 200–500 scale |
The CEHRS is the most specialized exam in this credential family: NHA reported 2,214 CEHRS exams in 2025, and 66.17% of all attempts passed. That figure counts every attempt, including retakes — treat it as context, not as your personal odds, but do treat it as a reason to prepare domain by domain rather than by general computer familiarity.
The five domains
| Domain | Exam questions (of 100 scored) | What it covers |
|---|---|---|
| 1. Non-Clinical Operations | 28 | Verifying patient identifiers before documenting; collecting and updating demographic, coverage, and preference data; generating encounter documents such as face sheets, labels, and armbands; retrieving data from internal and external sources; importing from scanners, fax, and signature pads; hardware inventory; coordinating patient flow; training end users; spotting and reconciling data discrepancies; supporting patient portal use; search techniques that prevent duplicate record numbers |
| 2. Clinical Operations | 32 | Building clinical templates for data capture; securely transmitting and exchanging patient data; reviewing clinical documentation for completeness and accuracy, including common charting errors; point-of-care support; entering real-time and historic clinical data; supporting computerized provider order entry; locating patient education materials; navigating the record to retrieve data on request |
| 3. Revenue Cycle/Finance | 15 | Finding codes in the system’s databases and entering billing information from the superbill; creating encounter forms and fee slips; verifying that documented diagnoses and descriptions support reimbursement; verifying coverage and eligibility inside the EHR; documenting authorizations; estimating patient costs; producing statements; collecting and posting payments |
| 4. Regulatory Compliance | 15 | Professional standards for health records; HIPAA Privacy Rule and HITECH confidentiality and security in daily practice; spotting and correcting non-compliant behavior; assigning and verifying role-based access controls; de-identifying protected health information; releasing information under the Privacy Rule and facility policy; internal EHR audits; abbreviation rules; downtime and data-recovery procedures; incentive-program requirements |
| 5. Reporting | 10 | Running standardized financial reports (aging, carrier, guarantor, procedure cost) and clinical reports that track outcomes; generating ad hoc reports from EHR fields; compiling statistical reports for quality-improvement measures, productivity, and research; preparing data for external reporting programs; verifying report accuracy before distribution |
Two emphases shape how to study. First, the exam rewards system judgment over button-pushing: discrepancy questions ask what to reconcile first, access questions ask who should see what, and documentation questions ask which error matters most. Second, there is a scope line running through the whole exam: the specialist safeguards, organizes, trains, and reports — clinical decisions and code assignment belong to other roles. Questions that invite you across that line are testing whether you know where it is.
The current test plan
The bank behind our CEHRS Exam Prep follows NHA’s CEHRS test plan, built from the 2019 practice analysis and in use since 2020. NHA has announced no successor plan, and the domain weights in the table above are the weights your exam uses.
Scoring, explained honestly
NHA converts your raw performance to a scaled score between 200 and 500, and 390 is the passing score. Scaled scores exist so that different versions of the exam can be held to the same standard; a 390 is not a percentage of anything, and there is no honest way to convert it to one. What you can control is coverage and accuracy in each domain. Our practice exams use a 70% practice benchmark purely as a readiness gauge — it is our number, not NHA’s.
Retakes and keeping the credential
If you do not pass, NHA requires a 30-day wait before your next attempt; after a third failed attempt, the wait becomes one year. Plan your first attempt accordingly. Once certified, the CEHRS renews every two years with 10 continuing-education credits and a renewal fee ($195 for the CEHRS; each additional NHA certification renews for $65).
A study plan that fits the blueprint
- Baseline: take a full practice exam and record your score by domain, not just overall.
- Drill the gaps: work the domain drills for your weakest domain — template design and access-control rules both improve fast with repetition.
- Re-test under time: take fresh full exams inside the 125-minute limit until your domain scores are consistent.
- Schedule: book your sitting while the material is warm, at your school, a PSI center, or by remote proctoring.
Start with the free 12-question sample on our CEHRS Exam Prep page, then decide if the full bank — 750 questions across all five domains — is right for your study plan. PassProfessor is an independent preparation provider: this program is not affiliated with NHA, and NHA does not endorse it.